Short description
Pat Davies provides a clear guide to the treatment of stroke patients based on Bobath concepts. Her approach to the rehabilitation of hemiplegic patients stresses the need to equip the patient for a full life, rather than setting arbitrary goals for functioning in the hospital or a sheltered environment. From the reviews: "I thoroughly recommend this book to physiotherapists and all others involved in the management of patients with adult hemiplegia." Physiotherapy
Description
This new edition of a best-selling guide incorporates significant advances in the early and later rehabilitation of neurologically impaired patients. Based on the Bobath concept, Davies' approach to stroke rehabilitation stresses the need to equip the patient for a full life, rather than setting arbitrary goals for functioning in a sheltered environment. Activities are described for encouragingthe recovery of active movements in more normal patterns as well as treatment to overcome oro-facial and perceptual difficulties. Ways to retrain functional walking, balance reactions and independence in daily life are explained and illustrated with 750 photographs of patients being treated.
Content
1 Problems That Cannot Be Seen Directly.- Problems Related to Disturbed Perception.- Some Common Problems Associated with Disturbed Perception.- Reciprocity of Perception and Learning.- Disturbed Perception and Learning.- Implications for Therapy.- Guided Movement Therapy (Guiding).- Therapeutic or Intensive Guiding.- Using Verbal Instructions.- How the Patient is Guided Therapeutically.- Choosing a Task.- Additional Considerations When Choosing a Task.- Guiding When Giving Assistance.- Guiding the Patient in a Standing Position.- Considerations.- 2 Normal Movement Sequences and Balance Reactions.- Analysis of Certain Everyday Movements.- Rolling Over from Supine to Prone.- Sitting, Leaning Forwards to Touch the Feet.- Standing from Sitting on a Chair.- Standing up from the Floor.- Going Up and Down Stairs.- Walking.- Balance, Righting and Equilibrium Reactions.- Lying on a Surface That Tilts Sideways.- Sitting on a Surface That Tilts Sideways.- Sitting, Being Drawn Sideways by Another Person.- Sitting with Both Legs Flexed and Turned to One Side.- Sitting, Reaching Out to Grasp an Object.- Standing, Tipped Backwards.- Standing, Tipped Forwards.- Standing, Tipped Sideways.- Standing on a Tilting Surface, Such as a Tilt-Board.- Automatic Steps to Maintain or Regain Balance.- Steps to Follow.- Balancing on One Leg.- Protective Extension of the Arms.- Task-orientated Arm and Hand Movements.- Considerations.- 3 Abnormal Movement Patterns in Hemiplegia.- Persistence of Primitive Mass Synergies.- The Synergies as They Appear in Association with Hemiplegia.- In the Upper Limb.- In the Lower Limb.- Abnormal Muscle Tone.- Typical Patterns of Spasticity or Hypertonicity.- Placing.- Reappearance of Tonic Reflex Activity.- Tonic Labyrinthine Reflex.- Symmetrical Tonic Neck Reflex.- Asymmetrical Tonic Neck Reflex.- Positive Supporting Reaction.- Crossed Extensor Reflex.- The Grasp Reflex.- Associated Reactions and Associated Movements.- Abnormal Tension in the Nervous System.- Disturbed Sensation.- Considerations.- 4 Practical Assessment a Continuing Process.- The Aims of Assessment.- Recommendations for Accurate Assessment.- Specific Aspects of Assessment.- Recording the Assessment.- The Comprehensive Evaluation.- The Head.- The Trunk.- The Upper Limbs.- The Lower Limbs.- Sitting.- Standing.- Weight Transference and Balance Reactions.- Walking.- Comprehension.- The Face, Speaking and Eating.- Sensation.- Functional Abilities.- Leisure Activities and Hobbies.- Considerations.- 5 The Acute Phase Positioning and Moving in Bed and in the Chair.- The Arrangement of the Patient s Room.- Positioning the Patient in Bed.- Lying on the Hemiplegic Side.- Lying on the Unaffected Side.- Lying Supine.- General Points to Note When Positioning the Patient.- Sitting in Bed.- Sitting in a Chair.- Re-adjusting the Patient s Position in the Wheelchair.- Learning to Propel the Wheelchair Independently.- Self-assisted Arm Activity with Clasped Hands.- Moving in Bed.- Moving Sideways.- Rolling Over Onto the Hemiplegic Side.- Rolling Over Onto the Unaffected Side.- Moving Forwards and Backwards While Sitting in Bed.- Sitting Up Over the Side of the Bed.- Lying Down from Sitting Over the Side of the Bed.- Transferring from Bed to Chair and Back Again.- The Passive Transfer.- The More Active Transfer.- The Active Transfer.- Incontinence.- Constipation.- Considerations.- 6 Normalising Postural Tone and Teaching the Patient to Move Selectively and Without Excessive Effort.- Important Activities for the Trunk and Lower Limbs in Lying.- Inhibiting Extensor Spasticity in the Leg.- Retraining Selective Abdominal Muscle Activity.- Control of the Leg Through Range.- Placing the Leg in Different Positions.- Inhibition of Knee Extension with the Hip in Extension.- Active Control at the Hip.- Selective Hip Extension (Bridging).- Isolated Knee Extension.- Stimulating Active Dorsiflexion of the Foot and Toes.- Rolling Over.- Activities in Sitting.- Correcting the Sitting Post
Blurb
A true paradigm shift is taking place in the field of neurology. Earlier it was regarded as the science of exact diagnosis of incurable illnesses, re signed to the dogma that damage to the central nervous system could not be repaired: "Once development is complete, the sources of growth and regeneration ofaxons and dendrites are irretrievably lost. In the adult brain the nerve paths are fixed and immutable - everything can die, but nothing can be regenerated" (Cajal1928). Even then this could have been countered with what holds today: rehabilitation does not take place in the test tube, being supported only a short time later by an authoritative source, the professor of neurology and neurosurgery in Breslau, Otfried Foerster. He wrote a 100-page article about thera peutic exercises which appeared in the Handbuch der Neurologie (also published by Springer-Verlag). The following sentences from his intro duction illustrate his opinion of the importance of therapeutic exercises and areclose to our views today (Foerster 1936): "There is no doubt that most motor disturbances caused by lesions of the nervous system are more or less completely compensated as a re sult of a tendency inherent to the organism to carry out as expedient ly as possible the tasks of which it is capable under normal circum stances, using all the forces still available to it with the remaining un damaged parts of the nervous system, even following injury to its sub
